مجله زنان مامائی و نازائی ایران
سال نوزدهم شماره 224 (اسفند 1395)

Pethedine is used to decrease labor pain. According to some studies, pethidine can be effective on labor progress. This study was performed with aim to determine the effect of pethidine on decreasing the duration of the first and second stages of labor.
This clinical trial was performed on 120 nulliparous women with term singleton pregnancy who needed induction of labor for pregnancy termination in Kosar hospital, Qazvin in 2013. They were randomly assigned in two groups of intervention and control (n=60). A single dose of 50 mg pethidine was injected intravenously at 4 cm cervical dilatation in intervention group. In control group, normal saline was injected as placebo. The intervals between the injection and complete cervical dilatation, the complete cervical dilatation and the end of delivery, and the injection and the end of delivery were measured. Data were analyzed by SPSS software (version 19) and student T-test and Chi-square test P The mean interval between the injection of pethedine and complete cervical dilatation was 129±70 min in intervention group and 133±75 min in control group and the difference was not statistically significant (P=0.7). The mean duration of second stage of labor was 45±26 min in intervention group and 41±16 min in control group and the difference was not statistically significant (P=0.3). The mean interval between pethidine injection and end of delivery was 175±79 min in intervention group and 174±83 min in control group and the difference was not statistically significant (P=0.39).
There is no significant relationship between pethidine injection and progression of the labor stages.

chromosomal abnormalities is the cause of more than 50-80% of abortions and the reasons of 4-28% of all mental retardations. Determining the fetal karyotype by chorionic villus sampling and amniocentesis are the gold standard methods for diagnosis of these diseases. Since these procedures are invasive and include at least 1% risk of fetal abortion, in recent years, different screening tests based on sonographic and biochemistry indexes are introduced and developed to determine who needs these invasive diagnostic methods. This study was performed with aim to assess the ratio of prenasal thickness to nasal bone length (PT/NBL) in fetal screening ultrasonography at second trimester of pregnancy.
This cross-sectional, analytic and descriptive study was performed on 500 healthy pregnant women with singleton fetus at 15-26 weeks of gestation in 2015. Ultrasound measurements of PT and NBL were performed on a midsagittal plane of fetal face. These measures were recorded in statistical table. Data was analyzed with SPSS software (version 22) and Statistica (version 10). P The mean of PT increased from 2.23±0.47 mm at 15 weeks to 4.32±0.9 mm at 26 weeks of gestation (P=0.001). The median of NBL increased from 4±0.17 mm at 15 weeks to 8.35±0.56 mm at 26 weeks (P=0.001). There was a linear relationship between PT and NBL with gestational age. The mean of PT/NBL was 0.5±0.78 which was constant during these weeks (P=0.89).
Gestational age, maternal age and fetal sex had no influence on PT/NBL ratio (P>0.05). So, this ratio can be used as an independent predictive factor for aneuploidies.

According to recent epidemiologic studies, the prevalence of breast cancer is growing in our country and has become a great concern for the researchers. Various studies in different regions and populations reported variable prognostic factors influencing on patient's survival. This study was performed with aim to evaluate the effective factors on prognosis of breast cancer patients in five-year period.
In this cross-sectional study, the information of all female breast cancer patients who had referred to Reza Radiation Oncology Center of Mashhad from 2007 to 2011were evaluated and the effect of different variables (include age, pathologic type, hormone receptors (ER,PR), and Her2 expression) on their survival was evaluated. Data was analyzed with SPSS software (version 18) and cox regression test and survival analysis. P Mean age of breast cancer patients was 49.13±11.57. Mean overall survival of patients younger than 48 years was 51.96 months and for those who were older than 48 years was 52.93 months that there was no significant difference between two groups (P=0.336). Cancer stage was significantly affected on overall survival and it was found that whatever the cancer stage is increased, the rate of overall survival is decreased (P=0.000). Overall survival significantly decreased with increased estrogen receptor expression (P=0.000).
Due to significant impact of clinical stage and estrogen receptor expression on patient's survival rates, as well as achieving the median age of about 48 years in patients, screening and identification of patients with poor prognostic factor in this age group it seems to be necessary.

Vaginismus is considered as one of the most common GenitoPelvic Pain/Penetration Disorders. The complication of vaginismus is extensive. Therefore, this study was performed with aim to investigate the efficacy of Cognitive Behavioral Therapy on catastrophic thoughts on women with vaginismus.
In this single-case experimental trial of multiple-baseline type, four women with vaginismus who had referred to Ahvaz psychosexual clinics in 2015 were recruited. Catastrophic thoughts were assessed in participants by multidimensional vaginal penetration disorder questionnaire at baseline and after the intervention. After determining the base lines in dependent variable, the subjects were respectively entered in Cognitive Behavioral Therapy and they were individually treated by 8 sessions per week. In this study, clinical significant is used. To analyzed data and evaluated the effectiveness this methods, used visuals or graphical chart analysis, diagnosis improve and six indicators Ingram.
After the treatment, all participants reported successful intercourse without pain and fear. The findings also showed that catastrophic cognitions significantly improved by Cognitive Behavioral Therapy in women with vaginismus (P The results of the study showed that Cognitive Behavioral Therapy can be considered as an effective treatment for vaginismus. Therefore, it is recommended to consider this therapy in the interventions for these patients; future studies with larger sample sizes and control groups is also suggested.

Delivery is potentially a stressful event. The maternal stress and anxiety, especially in the need for episiotomy, stimulates sympathetic system and leads to changes in vital signs which can have undesirable effects on maternal and fetal health. Therefore, this study was performed with aim to investigate the effects of entonox in comparison with lidocaine on vital signs during episiotomy incision in nulliparous women.
This randomized clinical trial was performed on 120 nulliparous women in 215. Intervention group received entonox two minutes before starting episiotomy incision and its repair and was stopped at the end of the incision procedure. Control group as routine received 5 ml lidocaine 2% before starting incision episiotomy. Vital signs were evaluated and compared before and after incision and episiotomy by pulse oximeter. Data were analyzed by SPSS software (version 18) and Mann-Whitney and Chi-square tests. PResuts: There was no significant difference between pulse, oxygen saturationbefore and after of incision and repair of episiotomy, respiratory rate after of incision and before of repair episiotomy and systole and diastole blood pressure before and after of incision and repair of episiotomy (P>0.05). There was significant difference between two groups in terms of respiratory rate before incision and after of episiotomy repair (P Eentonox gas same as lidocaine when is used correctly has no adverse effects on mother's vital sign.

Today, there are various methods of infertility treatment in medicine; one of the newest methods is surrogate uterine. This study was performed with aim to compare maternal-fetal attachment and pregnancy anxiety in surrogate women and normal pregnant women.
This Ex post facto study was performed on 30 women with gestational surrogate in infertility centers of Tehran in autumn and winter of 2015. Data was collected using demographic questionnaire, Cranley’s maternal- fetal attachment scale (MFAS) and depression, anxiety, stress scale (DASS21). The rate of maternal- fetal attachment and anxiety were determined by the questionnaires. Data was analyzed by SPSS software (version 21) and Leven’s test and independent t-test. P The mean score of maternal-fetal attachment in women with surrogate uterine was 86.06± 15.12 and in normal pregnant women was 95.93±8.52 (P≤0.05). The mean of anxiety in surrogate women was 6.8±3.47 and in normal pregnant women was 6±4.31 that the difference was not significant (P>0.05).
Maternal-fetal attachment is less in mothers with surrogate uterine than normal pregnant mothers, but anxiety level in surrogate mothers isn’t higher than normal mothers.

Violence against women is a universal phenomenon which has negative impact on the mental health of the family and society, and the consequences such as increased health care costs, reduced productivity and labor force of women are another results of this health and social cultural problem. So, this study was performed with aim to determine types of domestic violence and its related factors in pregnant women.
This descriptive-analytic study was performed on 368 pregnant mothers in area of Kalaleh in 2014. Data were collected by simple sampling and using a questionnaire. Data was analyzed with SPSS software (version 19) and descriptive statistics and Fisher's exact test, Chi-square, independent t-test, and Pearson correlation test.
312 pregnant women (84.78%) had been exposed to different types of violence. The most common type of violence against pregnant women was emotional with 181 cases (49.18%) and 78 (21.20%) complained of physical violence and 53 (14.40%) of sexual violence. Increased education reduced violence against women. There was a significant relationship between domestic violence, smoking and lack of husband's employment (P According to high rate of domestic violence, it is recommended to screen violence in the all health and therapy centers. Also, life skills training and counseling culture among couples is important.

Unicornate uterus is one of the congenital uterus abnormalities in several forms. In this article, we report a rare case of unicornate uterus with non-communicated rudimentary horn and active endometrium combined with the unilateral ovarian endometrioma undistinguished of it.
A 21 years old woman with acute abdominal pain and pelvic mass referred to Imam Reza hospital, Mashhad in 2015. Ultrasonography reported a bicornate uterus and a large cystic mass with size of 12.5×17.5 cm in the right ovary. CBC and tumour markers were normal, only CA-125 was increased. The patient was operated because of the acute abdomen. In the explanatory laparotomy and hysteroscopy, a unicornate uterus with right accessory corn combined to the right ovary was showed that they formed a unique cystic mass contained a chocolate liquid. Rudimentary horn accompanied by the right ovary and falopan tube were resected. Histopathological report confirmed simultaneous endometrioma of the right ovary and hematometra in the rudimentary horn.
Unicornate uterus with non-communicated rudimentary horn and active endometrium may be associated with hematometra and/or endometrioma. The accumulation of chocolate like fluid may lead to destroy of ovary tissue and elimination of rudimentary horn coincide with oophorectomy seemed unavoidable. Therefore, early diagnosis and removal of rudimentary horn can avoid of complication such as endometriosis, oophorectomy and ectopic pregnancy.